Please complete the following and return with payment to Master Brewers headquarters.
First Name (Nombre) ____________________________________________ Initial ____________
Last Name (Apellido) ______________________________________________________________
Title (Cargo Actual) _______________________________________________________________
Company Name (Nombre de la Empressa) ______________________________________________
Business Mailing Address (Direccion de Oficina) _________________________________________
________________________________________________________________________________
City (Ciudad) ________________________________ State/Province (Estado/Provincia) _________
Zip/Postal Code (Codigo de Postal) ________________ Country (Pais) _______________________
Business Phone (Telefono Oficina) ____________________________________________________
Mobile _________________________________________________________________________
E-mail __________________________________________________________________________
Course Tuition: __________ Member $2,499
__________ Nonmember $2,899
__________ Course + Membership $2,648
Payment Options:
For your security, do not submit this form by email.
❏ Check (U.S. funds only—Payable to Master Brewers)
❏ Charge my: ❏ VISA ❏ MasterCard ❏ American Express
Credit Card Number_________________________________________ Expiration Date _________
Cardholder’s Name ___________________________________________ Security Code _________
Signature ________________________________________________________________________
When you provide a check as payment, you authorize us to use information from your check to make a one-time
electronic fund transfer from your account or to process the payment as a check transaction. Funds may be
withdrawn from your account the same day we deposit payment and you may not receive your check back
from your nancial institution.
If you have any special needs, accommodations, or requirements, please indicate them here:
_________________________________________________________________________________________________
Mail or fax completed form with payment to:
Master Brewers Education Registrar
3352 Sherman Ct, Suite 202, St. Paul, MN 55121, U.S.A.
Fax: +1.651.454.0766
2021 Brewery Maintenance Systems Course
August 15–September 24, 2021
Expected Behavior
We are dedicated to providing a harassment-free
conference experience for everyone, regardless
of gender, sexual orientation, disability, physical
appearance, body size, race, or religion. We
do not tolerate harassment of participants in
any form. We ask all attendees, exhibitors,
speakers, sponsors, volunteers, guests and other
participants be considerate and respectful to
all members and refrain from demeaning,
discriminatory, or harassing behavior and
speech. Please note, if you register a guest for
the meeting, you may be held responsible for
the actions of the guest. Violations of this policy
should be reported to meeting staff.
Master Brewers reserves the right to remove
any individual from attendance or other
participation in any Master Brewers sponsored
event without prior warning or refund, and
to take additional action as determined
necessary, up to and including expulsion from
participation in Master Brewers. Any course of
action recommended by Master Brewers is final.
Course Resources
By registering for this course you agree that all
course content is provided solely for the purpose
of completing the Brewery Packaging Technology
Online. Course content cannot be recorded,
duplicated or distributed.
Cancellations/Refunds
Only applications accompanied by the registration
fee, paid in full (US funds only), will be accepted.
Cancellations received by Master Brewers
Headquarters on or before July 16, 2021, will
be issued a credit equal to the registration fee less
$100 processing fee, which will be good for two years
toward any Master Brewers continuing education
program. Notices of cancellation after July 16, 2021,
will not be eligible for a refund or credit. Master
Brewers reserves the right to cancel the course if a
sufficient number of registrations are not received by
July 16, 2021. If Master Brewers cancels this course,
your registration fee will be refunded in full. By reg-
istering for this course, you agree to the cancellation
and refund terms and conditions. You must be 21
years of age or older to attend this course.
If you have any questions, contact Master Brewers
by phone: +1.651.454.7250, website: mbaa.com or
e-mail: mbaa@scisoc.org.
click to sign
signature
click to edit
![]()
